Public Accommodation Request

* indicates a required field

Student Information

This section will go over basic background information.
Please provide your name as it appears on your legal documents (e.g., birth certificate, passport, or government-issued ID.
Please provide your name as it appears on your legal documents (e.g., birth certificate, passport, or government-issued ID.
This is the name you would like us to use when addressing you (e.g., nicknames, shortened versions, or chosen names. This will be the name that appears on your accommodation letter.
A series of 9 numbers typically beginning with 001
Your SUNY Albany-issued email address will be used for confidential communication and to connect your information with university systems.
Please share your pronouns if you would like us to use them when communicating with you (e.g., she/her, he/him, they/them).
What is your living situation?Required
Class Status at Registration
{"display_name":"Class Status at Registration","hidden_field_name":"ms_field_1","init_id":"ms_field_1","init_link":"","has_autocomplete":false,"has_hierpicklist":null}
Enrollment Status at Registration
{"display_name":"Enrollment Status at Registration","hidden_field_name":"ms_field_2","init_id":"ms_field_2","init_link":"","has_autocomplete":false,"has_hierpicklist":null}
If you are transferring or visiting from another institution, list it here.
What is your academic focus? (e.g., Sociology, Information Science, Psychology, Computer Science, etc.) Please put 'undecided' if you have not yet decided on a major.
If you have a minor, please list it here.
Are you affiliated with any of the following agencies/programs?




Are you an active member of the armed forces, a veteran, or the dependent of an active service member or veteran?
{"display_name":"Are you an active member of the armed forces, a veteran, or the dependent of an active service member or veteran?","hidden_field_name":"ms_field_3","init_id":"ms_field_3","init_link":"","has_autocomplete":false,"has_hierpicklist":null}

Specific Accommodation Information

Please provide your diagnosed disability as documented by a healthcare provider. Examples include ADHD, autism, anxiety, or physical disabilities. If you are in the process of diagnosis or seeking resources, please share that as well
Describe the primary symptoms associated with your diagnosis. Examples may include difficulty concentrating or maintaining focus, challenges with organization and time management, or sensory sensitivities such as sensitivity to light, sound, or textures. If you experience mobility limitations, this could include difficulty walking long distances, navigating stairs, muscle weakness, joint pain, or the need for assistive devices like a cane, walker, or wheelchair.

Please describe how your symptoms affect your learning and ability to complete coursework. This may include difficulty concentrating in lectures, challenges with note-taking or retaining information, trouble meeting deadlines due to executive functioning difficulties, or needing extra time for exams. Mobility limitations might make it difficult to navigate campus or attend in-person classes, while sensory sensitivities could impact focus in noisy or bright environments. Chronic pain or fatigue may affect attendance and stamina for academic tasks. Providing specific challenges will help us better understand and support your needs.

Tell us about accommodations you received in high school or at your last institution. If none, feel free to skip this question.
Upload supporting document(s)
Please upload recent, clear, and official documentation. Examples include medical provider letters, IEPs/504s, or past accommodations. If you do not have documentation, we can still meet to explore options. Submit documentation later when available.
What type of accommodations are you requesting?Required
Are you requesting any of the following accommodations ?Required
Select all that you are requesting.
Are you requesting anything in addition to the accommodations above or not listed?Required
Please note: Check yes if requesting any Housing or ESA related accommodations as well as further Academic Accommodations